Exergaming and static postural control in individuals with a history of lower limb injury

Abstract

Context: Therapeutic exercise programs that incorporate real-time feedback have been reported to enhance outcomes in patients with lower extremity joint injuries. The Wii Fit has been purported to improve balance, strength, flexibility, and fitness.

Objective: To determine the effects of Wii Fit rehabilitation on postural control and self-reported function in patients with a history of lower limb injury.

Design: Single-blinded, randomized controlled trial.

Setting: Laboratory.

Patients or other participants: Twenty-eight physically active participants with a history of lower limb injuries were randomly assigned to 1 of 3 groups (9 Wii Fit, 10 traditional, 9 control).

Intervention(s): Intervention groups performed supervised rehabilitation 3 d/wk for a total of 12 sessions.

Main outcome measure(s): Time to boundary (TTB) and the Star Excursion Balance Test (SEBT) were conducted at baseline, 2 weeks, and 4 weeks. Self-reported function was measured at baseline and 4-week follow-up. Between-groups differences were compared using repeated-measures multivariate analysis of variance.

Results: With the eyes open, both intervention groups improved (P < .05) in the mean and the SD of the TTB anterior-posterior minima. In the eyes-closed condition, a time main effect (P < .05) for absolute TTB medial-lateral minima was observed. A time main effect was also noted in the posteromedial and posterolateral reach directions of the SEBT. When the scores for each group were pooled, improvement (P < .05) in self-reported function was demonstrated at 4-week follow-up.

Conclusions: Rehabilitation using the Wii Fit and traditional exercises improved static postural control in patients with a history of lower extremity injury.

Figures

Appendix A.

Wii Fit rehabilitation protocol. Rehabilitation should be 3×/wk for no more than 15 minutes. Participants began the first session with a 15-minute assessment of body composition and current balance. Each participant began with soccer heading each time he or she began the Wii Fit program. The Wii Fit program was set up to provide additional activities and levels based on the individual's accumulated time. Participants could move on to the advanced levels when 3 stars were achieved in the basic level.

Appendix B.

Traditional rehabilitation protocol. Rehabilitation should be 3×/wk for no more than 15 minutes. Changes are in bold. Start at a challenging level. When proficient in activity, advancement can be made. A phase from each category must be done in each session.

Figure.

Flow diagram of participants throughout the study. Abbreviations: SEBT, Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; TTB, time-to-boundary measures in the eyes-open and eyes-closed positions; and LEFS, Lower Extremity Functional Scale.